The present invention generally relates to insurance authorization.
Frequently, a healthcare insurance provider will require authorization prior to care provision or subscription. For example, insurance providers commonly require prior authorization (PA) based on a patient's insurance plan, medical condition, and the medication or treatment being prescribed. This has traditionally been a manual process, but in January 2013, the National Council for Prescription Drug Programs, (NCPDP) an ANSI-accredited, standards development organization providing healthcare solutions, announced extensions to their messaging standard to include prior authorization.
Needs exist for improvement in electronic authorization. These, and other needs, are addressed by one or more aspects of the present invention.